The activities of alkaline and acid phosphatase were determined in the mucosa of seventy resected stomachs with various diseases. In this report a special reference is made concerning intestinal metaplasia. 1. In the normal gastric mucosa, distribution of alkaline phosphatase was limited to capillary walls, endothelium of blood vessels and reticular fibers in the periphery of lymph follicles. In atrophic parts of the mucosa, positive reactions of metaplastic epithelium and granular leucocytes were also noted. 2. The distribution of acid phosphatase was different from alkaline one. Even in the normal gastric mucosa, acid phosphatase-activity was observed in varying degrees in surface and glandular epithelia and various kinds of interstitial migrating cells, but it was far weaker in capillary walls, blood vessel endothelium and reticular fibers in the periphery of lymph follicles than alkaline phosphatase-activity. On the other hand, metaplastic epithelium in the mucosa with atrophic changes showed an intense activity of acid phosphatase, while granular leucocytes were practically devoid of the activity. 3. Some of the gastric epithelial cells with intestinal metaplasia resembled the common epithelial cells of the small intestine in morphological appearance and phosphatase-activity (typical metaplastic cells), while others differed in the forms and phosphatase-activity from the normal intestinal epithelium (atypical metaplastic cells). 4. In the normal small intestine, all the common epithelium of the villi except their roots was occupied by cells showing intense alkaline and acid phosphatase-activity. On the contrary, however, in the intestinal metaplastic epithelium of the gastric mucosa, these intensely activated cells either decreased in number or disappeared, and frequently the superficial part of the metaplastic mucosa was lined by the aforementioned atypical cells and the typical ones similar to the epithelium of the roots of the intestinal villi or the upper halves of the crypts, which were all weaker in phosphatase-activity. 5. Metaplastic epithelium which occurred in the regenerative areas, such as the area surrounding the erosions and ulcers, the surface of scar tissue and so on, showed weak alkaline and acid phosphatase-activity. However, as the atrophic changes progressed, phosphataseactivity gradually increased. 6. Alkaline and acid phosphatase-activity of metaplastic epithelium were generally intense in the stomachs with anacidity, high degree of intestinal metaplasia and cancer, but, on the contrary, weak in those with hyperacidity, slight degree of intestinal metaplasia and chronic gastritis. In addition, the phosphatase-activity of metaplastic epithelium was more intense in the fundus than in the pyloric regions.
In an attempt to solve a function of the gastric secretion, experiments were made chiefly on the changes of carbonic anhydrase (hereinafter referred to as C. A.) activity and that of the fine structure of the parietal cell, through the administration of various medicaments efficacious against either stimulating or inhibiting the secretion of gastric juice. The experiments also included the influences observed on the intra-mucosa clectrolytes (Na+, K+, Cl-), intra-juice electrolytes, and blood C. A. activity, with thefollowing findings: 1) The medication of Histamine dihydrochloride intensified the gastric C. A. activity of rats; in the fine structure of parietal cell the mitochondria became ramified and enlarged; the vesicles diminished in number and gathered around the intra-cellular canaliculi; the intracellular canaliculi developed and were choked completely with the grown microvilli. 2) Following the administration of Acetazolamide, the gastric C. A. activity decreased significantly. Even when it was used together with Histamine, no effect of histamine was observed whatsoever. In the fine structure of the parietal cell, the vesicles enlarged with a remarkable increase in number. The intra-cellular canaliculi became indistinct, and the microvilli diminished in size. These findings, together with the decreased secretion of gastric juice, can be considered as an important factor in solving the function of gastric secretion. 3) The activation of the gastric C. A. activity of dogs was approximately seven times high in the courpus region, as compared to that of the pyloric region. This finding, together with the observation of the variations in the gastric C. A. activity and the changes in the fine structure of the parietal cell, caused by the medication of Histamine and Acetazolamide, strongly suggests that the gastric C. A. has some relations with the parietal cell. 4) With the use of Chlormerodrin, the gastric C. A. activity of rats showed a certain decline; however, its effect was much lesser than that of Acetazolamide. In the fine structure of the parietal cell, the mitochondria became diminished, while the cristae mitochondriales were found dense and the electron density of the mitochondria matrix was high. Therefore, the finding also suggests the presence of a definite relationships between the succinic dehydrogenase and the mitochondria. 5) When Atropine was administered, no variations in the gastric C. A. activity of rats were observed. When used together with Histamine, the C. A. activity by Atropine was lower than that of the sole use of Histamine. In the fine structure of the parietal cell, no changes other than the increase in the vesicles was observed. When Histamine was used together, its influence had not existed. During the course of the observation, a definite relationship between the gastric C. A. activity and the fine structure of the parietal cell apprently existed. 6) Upon administration of Prednisolone and Urethane, there was no varietions in the gastric C. A. activity of rats; however, when Histamine was used together with the foregoing medicaments, the C. A. activity increased. In the fine structure of the parietal cell, it is observed that the Prednisolone decreased the vesicles and the expansion of the intracellular canaliculi, the elongation of the microvilli, and the swelling of their tips. The administration of Urethane alone produced no change. When used together with Histamine, it produced similar changes in the vesicles and the intra-cellular canaliculi, as caused by the sole use of Histamine, and showed similar vicissitudes of the C. A. activity. 7) Following the administration of Ouabain there observed no changes in the gastric C. A. activity of rats. However, when used together with Histamine, it resulted in lower activation than that of the sole medication of Histamine, and the depression of the gastric acid secretion.
In 65 patients complaining of digestive symptome among 100 cases of pulmonary tuberculosis observed between April 1964 and desember 1966, the tender points of pancreatic disease Kudo) and various pancreatic function tests were studied. Further detailed clinicla studies were carried out in those who showed abnormalities. Following results were obtained. 1) In 65 patients complaining of digestive symptoms among 100 cases of pulmonary tuberculosis, agreement of both tender points of pancreatic disease and endocrine and exocrine function tests of pancreatic function was seen in 32 cases, representing 32% of patients with pulmonary tuberclosis and 51.6% of patients with digestive complaints. Frequent occurrence or pancreatitis in pulmonary tuberculosis was sugested. 2) An exellent agreement between tender points of pancreatic desease and endcrine and exocrine pancreatic function test might indicate the clinical value of tender points of pancfcatic desease in the diagnosis of pancreatitis. 3) In the relationship between abnormalities in pancreatic disease and antituberculosis preparation, disturb ance in pancreatic function was more frequently found in patients given PAS than in those without PAS treatment, indicating a significant difference. 4) In 10 of the patients with abnormal pancreatic function, pancreozymin-secretin test was carried out to determine the amount of pancreatic secretion, maximum concentration of bicarbonate, total amylase concentration, and amylase output. Lower values than in controls were encountered in 9. 5) Clniical examination in patients with abnormal pancreatic function revealed, cases stomach in gastric fluorescopy, anacidity or hypoacidity in gastric analysis, abnormalities in liver function was seen in 18.8%, and hypocalcemia in a few cases. In cholecystography and examination of the duodenal juice, complication of cholecystopaty was frequently noted, suggesting the profound relationship of cholecystopaty on pancreatitis in patients with pulmonary tuberculosis.